Spring 2002

Articles from the Spring 2002 Issue

Switching on to Shakespeare: A Midsummer Night’s Dream.

Park K. (2002)

This article describes how two groups of pupils with severe and profound learning disabilities participated in a series of poetry workshops at Shakespeare’s Globe Theatre. Shakespeare’s monumental and enduring influence on English language and culture are described in a quotation by Bernard Levin. The aim of the workshops was to include people with multiple disabilities in this shared cultural heritage, and to develop the participants language and communication skills. The text of the six activities from A Midsummer Night’s Dream is displayed. Each of the activities was initiated by a switch user and contains extracts of poetry from the original play. The workshop materials have been used in school classrooms as well as onstage at the Globe, requiring only a few props and staff enthusiasm to be done anywhere.

The early intervention gap–can we fix it? (Yes I CAN!).

Hall A. (2002)

Most therapists assume that specialist educational placements for preschool children with persistent speech and language difficulties would have good outcomes but be too expensive to provide. This article describes how I CAN’s pioneering Early Years Centres have made a significant improvement in provision and effectiveness in an evaluation study. The evaluation by Law & Dockrell showed that children who attended the two I CAN Centres made greater improvements in productive vocabulary, language comprehension scores, and adaptive and social behaviour than a comparison group. The I CAN Centres can have different models of provision to accommodate local factors. The main features of the Centres are listed, and include integrated delivery of speech and language therapy and preschool education, parental involvement, participation in mainstream nursery environment, and outreach activities. Appropriate early provision prevents the development of secondary difficulties with behaviour in school-age children. Children with the most severe language comprehension difficulties made the greatest improvements under the I CAN provision. Surprisingly, the costs associated with this intensive, integrated provision were less than those of the comparison group receiving separate NHS speech and language therapy and preschool education provision. The study highlights the benefits of collaborative working between therapists and teachers in the early years setting.

Making the case for change.

Mair E, Scott AH. (2002)

While other professions in the multidiscipline team often recognise the value of referral for feeding disorders in very young children, referrals are often delayed. This article argues for earlier speech and language therapy involvement in the multidisciplinary team in the treatment of feeding difficulties in pre-term infants to reduce medical and neurodevelopmental sequelae through the use of individualised developmental supportive care. The main characteristics are listed, including the importance of reducing lighting and noise levels, the positioning and handling of the infant, parental participation, and the value of non-nutritive sucking. The sensory experiences of the premature infant in intensive care are discussed in relation to the need to develop awareness, attention, social interaction, and sensory activities. Tube feeding, cup feeding and nipple feeding are discussed. Implementing this values-based system of developmental supportive care in Scotland has been slow and difficult, since it required a change in practice within neonatal intensive care units.

Preliminary findings of an informal longitudinal study into the research/practice interface: noting the influence of extra trees in the wood rather than throwing the baby out with the bath-water.

Irvine C. (2002): p16-7

The challenges faced while attempting to evaluate the effectiveness of intensive speech and language therapy intervention in adults with learning disability are described in a tongue-in-cheek fashion. Controls were inadvertently interfered with, instructions ignored and, when the changes in service users were noticed by management, the researcher was sent off around the county to provide intensive interaction training in the middle of the project. A second project on the development of an understanding of negatives was disrupted when the three staff involved variously went on maternity leave, were promoted, and went off sick with stress, and the results were never written up. Based on her experiences, the author suggests an alternative guide to conducting research in practice.

Let your mats do the talking.

Murphy J, Cameron L. (2002)

Therapy tools are only as successful as the practitioner who uses them. This article describes a multidisciplinary training course in the use of “Talking Mats”, a visual framework which uses picture symbols to help people with communication difficulties in a residential setting make peer interactions. After an explanation of issues central to the effective use of Talking Mats, the participants from a variety of health and ancillary occupations were expected to video their use of the Talking Mats with a client between the two sessions. The way in which the Talking Mats were used with specific clients and their potential for the workplace are examined.

From dilemma facing to decision making.

Graham F, Davison A. (2002)

Complex ethical dilemmas are an everyday occurrence for all health professionals, including speech and language therapists. This article reports how a one day conference focussing on training in medical ethics as applied to dysphagia management has improved the authors’ team working, note keeping, confidence and objectivity. Presentations on the importance of nutrition following stroke, the use of PEG feeding, the prognosis with different types of dementia, and the four principles of medical ethics – autonomy, beneficience, non-maleficience, and justice – are described. The case of a 90-year-old man with a diagnosis of dementia and dysphagia is considered from an ethical viewpoint, and as part of a team discussion. A contrasting case of a 28 year old woman admitted following severe head injury is also considered. The need for training in medical ethics as part of undergraduate and postgraduate training in speech and language therapy is raised.

How . . . I manage deafness in children and young people.

Be proactive.

Fairweather L. (2002)

The effect of otitis media on the language of the developing child is examined. This article considers the management of children with otitis media (glue ear) and speech and language difficulties. Although there are no definitive answers in providing advice to parents, it is suggested that therapists should be proactive and adopt a holistic approach to the developing child. The effect of prolonged repeated upper respiratory tract infection on otitis media, the timing and need for speech and language therapy intervention, and the impact of background noise on auditory processing are examined. The examination of functional hearing level and follow-up of hearing assessment are important, and speech and language therapy should concentrate on perception rather than production.

Enthusiasm, empowerment and equity.

Kraft L. (2002)

The provision of an equitable service to deaf children in the Highland Primary Care NHS Trust region of Scotland, a vast remote area, depends on using the skills of local generalist therapists and other professionals to ensure that the best possible practice is available to all. The work is totally integrated with the Highland Deaf Education Service. This article describes how the service is provided to children with cochlear implants as well as those with hearing aids, and how local generalist therapists are empowered to use skills they already posses, as well as attending courses to develop their skills. The difficulties of recruitment and providing support in the remoter areas of the Highlands are also mentioned.

The ultimate outcome measure.

Howden S. (2002)

For many deaf children, lip-reading does not come naturally. This article describes how teamwork by different agencies working together ensures that the effort required by deaf teenagers to master this skill is recognised and rewarded. Four learning outcomes for students studying for the Scottish Qualifications Award in Lip-Reading are listed. These include coping strategies, participating in group discussion, and the ability to comprehend and respond to a series of short sentences by a variety of speakers in different settings. In order to be qualified to assess the module for the children, the author undertook the Scottish Qualification Agency’s (SQA) Assessor’s Award. The result was a satisfactory outcome for both the pupils and the assessor.

My top resources.

Patterson A. (2002)

As is often the case, the best resources identified by students and clinicians are not necessarily pieces of equipment but are often human. This article lists and describes the pre-placement pack, the student’s clinical information file, peer and tutor support, induction pack and handbook, time, interpersonal skills via video recording, clinical supervisors and teachers, as well as basic equipment and a sound knowledge base.